Method of installing a final dental prosthesis

ABSTRACT

A cradle, assembly, system and method for installing a prosthesis at a surgical site. The cradle temporarily engages the prosthesis and holds it in the correct orientation and position adjacent the surgical site. An aperture is defined in the cradle and a portion of the prosthesis is received therein. In one embodiment, the cradle, assembly and system are used to install a final dental prosthesis in a patient&#39;s mouth in a single visit to the dentist&#39;s office. A securement member pins the surgical template and subsequently the cradle to the jaw. A metal sub-structure on the final dental prosthesis is received in the aperture in the cradle. Cylinders attached to implants anchored in the jaw extend through holes in the sub-structure and are bonded to the prosthesis. The cradle is detached from the jaw and from the prosthesis prior to screws being re-inserted through the cylinders and into the implants.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. patent application Ser. No.13/648,359 filed Oct. 10, 2012, the entire disclosure of which isincorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

Technical Field

This invention relates generally to medical devices and their method ofuse. More particularly, this invention relates to prosthetic devices orprosthetic device parts. Specifically, this invention is directed to acradle, system and method for correctly positioning and orienting aprosthetic device at a surgical site and is most specifically directedto a cradle used to position and orient a final dental prosthesis in apatient's mouth.

Background Information

It has become more common in recent years for prosthetic devices andprosthetic device parts to be used to replace missing body parts. Theseprosthetic devices and parts can take a variety of forms but aregenerally components which are used to replace damaged or missing partsof the human body and range from devices and parts used to replace softtissue components to fabricated replacement parts. In this description,all such components will be generally referred to a prosthetic devicesbut it will be understood that this term should not be narrowlyconstrued to only be limited to particular components.

Prosthetic devices frequently require that very specialized surgery beperformed to install the same at a surgical site in the patient's body.One of the issues that arise in these surgeries is that the prosthesishas to be retained in a very particular orientation and position whilethe specialist is securing the prostheses in place.

By way of example, one of the fields in which this has been an issue isin the installation of dental prostheses, most particularly fixedprostheses. Dentists have been replacing teeth with prosthetic devices,also referred to by the general public as “false teeth”, for many years.When one tooth or a few teeth are missing, it is relatively easy for adentist or an oral surgeon to have the missing tooth or teeth fabricatedand to install the same. (In the rest of this description, the term“dentist” will be used to represent any professional who installs dentalprostheses.) One of the prime reasons that this is possible is that thedentist is able to use the remaining teeth as landmarks for positioningand orienting the replacement tooth or teeth. It is far more difficultwhen the patient is missing all of their teeth on the upper or lower jawor on both of the upper and lower jaws. This is because there are nofixed or immovable landmarks on that jaw for the dentist to use tocorrectly position and place the dental prosthetic device.

One of the systems which has been developed to try and aid dentaldentists to assist edentulous patients, i.e., patients who are missingentire jaws of teeth, is that invented and marketed by Nobel Biocare AB,of Sweden as the ALL-ON-4 ® system. This system is covered by a numberof patents including but not limited to U.S. Pat. No. 7,950,924(Brajnovic), U.S. Pat. No. 8,186,999 (Andersson et al), U.S. Pat. No.8,234,000 (Andersson et al), and U.S. Pat. No. RE43,584 (Andersson etal), the entire specifications of which are incorporated herein byreference.

The system will be described with reference to a patient who has beenwearing a non-fixed denture. The non-fixed denture is marked withradio-opaque-markers and, while the patient is wearing the denture, a CTscan (i.e., a computed tomography scan) will be taken of the patient'smouth. The scan will pick up the radio-opaque markers. The non-fixeddenture is then scanned by itself in the CT scanner and all of the datafrom these two scans is fed into a computer. The computer includesprogramming which analyses the data and generates an exact image of thedenture or prosthetic it needs to create to replace the patient'smissing teeth. The program allows for manipulation of the image of thescanned jaw and prosthetic so that decisions can be made as to where toplace the implants that are necessary for fixing the prosthetic to thepatient's jawbone during surgery. The denture shows up on the scan andcan be removed or inserted as needed. When the optimum position of theimplants is determined, based on the anatomical landmarks of the oralcavity and jawbone visible in the scan, the denture is then insertedback into the image to ensure that optimal anatomical placement of theimplants coincides with their optimum placement within the parameters ofthe prosthetic. This is important to ensure that the implants and anyabutments extending therefrom will emerge from the jawbone through theprosthetic in a complementary position. The implant position andangulation is then manipulated on screen to ensure that any abutmentswill be positioned so that they are hidden behind the teeth on thepalatal aspect (upper jaw) and/or lingual aspect (tongue side on thelower jaw).

Once the position of the various components is finalized on thecomputer, the program generates a parts list and creates the surgicaltemplate which is able to deliver this exact placement of the implantsand abutments in the patient's mouth. The computer is connected to amanufacturing assembly and it controls the fabrication of a surgicaltemplate for the dental prosthetic. In particular, the computer uses thedata to generate a milled pattern replica out of a clear composite resinwhich is identical to the denture relative to the tissue-fitting surfaceand border extensions. The surgical template is fabricated to the exactspecifications determined by the scans. Special holes are drilled intothe surgical template during fabrication to indicate the positions atwhich the implants must be placed to anchor the prosthetic into thepatient's jaw. The ALL-ON-4 system made by Nobel Biocare requires onlyfour implants to anchor a fixed prosthetic properly. The implants aremeant to be placed into the jawbone in very precise locations and atspecific angles that are determined by the computer. The computer alsodesigns the prosthetic and once the implants are installed, theprosthetic is engaged with the implants.

Nobel designed this system with the intention that after the initialscans and production of the surgical template and prosthetic, the actualinstallation of the fixed prosthetic would be accomplished in a singlevisit to the dentist's office. But, the system does not function in thisfashion in reality. The problem appears to originate in the fact thatwhile the computer is incredibly accurate in creating the surgicaltemplate and the final prosthetic, the human dentist is less accuratethan the system requires—simply because they are human. When thesurgical template is positioned in the patient's mouth, it is seated onthe gum tissue. When the dentist drills the hole in the jawbone for anyone of the implants, the gum tissue may deform, thereby slightlyshifting the location or the angle at which the implant is installed inthe jaw. Additionally, implants are designed to be torqued to a veryspecific tolerance (i.e. they have to be rotated a very specific numberof turns). If they are rotated even slightly more than they should bethey can be inadvertently countersunk in the jaw. They may also beunder-rotated into the jaw, rendering the implant too high. Dentistswill also frequently adjust the torque on the implants once the surgicaltemplate is removed. Then when the prosthesis is engaged with theimplants, it will not be seated properly. When this seating imbalanceoccurs, too much load is placed on one or more of the implants and theywill tend to fail fairly rapidly. At the same time, the fixed prosthesiswill not function properly as it will tend to move and put pressure onthe patient's jaw.

Because of these problems, the Nobel system is used differently inpractice. It has become necessary for the dentist to install theimplants and the final fixed prosthetic device in separate visits. Inthe first visit, the dentist will take all of the necessary CT scans andwill send the data to Nobel Biocare for fabrication of the surgicaltemplate. In the next visit, the dentist will install the implants inthe jaw, attach temporary cylinders to the implants, and then place atemporary denture, also known as a transitional prosthesis, around thosecylinders. In this previously known method of installation, as part ofthe procedure, it is necessary to use pre-fabricated temporary cylindersof uniform size to link the transitional prosthesis to the implantsbecause of the issues with the installation of the implants. When thesetemporary cylinders are bonded to the transitional prosthesis, theytypically have to be cut down so that they are substantially flush withthe mouth-facing wall of the transitional prosthesis so as not topotentially injure the patient during use.

Transitional prostheses are typically of fairly poor quality as they arenot meant to last more than a few months while ossification of theimplants occurs, i.e., while bone grows around the implants. It takes agreat deal of time and effort to even install the transitionalprosthesis because of the previously mentioned issues with theinstallation and/or degree of torque of the implants. As a result, ithas become commonplace for dentists to hand this job over to dentaltechnicians. A transitional prosthetic is fabricated from acrylic andthis components does not include a metal sub-structure. The materialused in the transitional prosthesis allows the dental technician toseat, grind, shape, and cut the transitional prosthesis until it fitsadequately around the cylinders on the patients' jaw. It can takeseveral hours of time and considerable effort to even get thesetemporary devices to fit. The patient then has to go away for severalmonths, living with these inferior prostheses while they wait for boneto grow around the implants and secure them in place. Previously knowntemporary or transitional prostheses are notorious for having pooraesthetics, bite issues causing chewing problems, discomfort and theyare known for premature failure during use.

When the patient returns to the dentist for yet another visit, theimplants have become embedded in the jaw and the dentist will take a newimpression of the patient's jaw and implants. This impression is used tofabricate the final prosthetic device which will fit the actual positionof the implants that were previously placed in the patient's jaw. Thisactual position tends to differ significantly from the original positionthe computer calculated because the tolerances involved are so tight.The final prosthetic device is comprised of a titanium sub-structureonto which is attached fabricated teeth and a simulated gum. The teethand simulated gum are fabricated from acrylic or porcelain and aresecured to the titanium sub-structure. The titanium sub-structurestrengthens the final prosthetic device. After finalizing the design ofthe prosthetic device, the computer controls the production of thetitanium sub-structure. A dental laboratory will typically be utilizedto attach the teeth and simulated gum to the sub-structure and then thefinal prosthetic device is shipped back to the dentist for insertion.

The computer program will also generate a list of the required fixturesand fasteners for securing the transitional prosthesis to the implantsand a second list of the required fixtures and fasteners for securingthe final prosthesis to the implants. In this previously known system,the various components for the dentist are shipped in at least twoshipments. The first shipment includes the surgical template and theimplants from Nobel Biocare and the transitional prosthesis from thedental laboratory. The second shipment, which is shipped several monthslater, includes the final prosthesis and the second group of fixturesand fasteners. It should be noted that the transitional prosthesis hasto be substantially altered and modified after implant placement withunpredictable results as previously described. Furthermore, the finalprosthesis is only fabricated after a complete round of separateappointments including appointments for taking impressions, biteregistration, and trying on of the prosthesis prior to finishing, inorder to check aesthetics and bite. The final prosthesis is only thenfixed in place by the dentist in a separate final appointment. Theentire process from start to finish takes approximately one year tocomplete.

The above description applies to a guided installation procedure. It isalso possible to install a fixed prosthesis using an unguided orfreehand installation procedure. In previously known freehand orunguided installations a computer is not utilized to scan a patient'smouth, compile and analyze data accumulated during a scan, nor is acomputer used in the fabrication of the surgical template, thetransitional prosthesis, or final dental prosthesis. Previously knownfreehand installations include the following steps. Firstly, the dentisttakes an impression of the patient's oral cavity and takes relevantX-rays. The dentist or a dental technician will then make a plastermodel from that impression and will craft a surgical template, and atemporary dental prosthesis based on the plaster model. Biteregistration, a try-in and X-rays help the dentist determine the bestplacement of implants and that information will be transferred onto themodel in order to correctly position holes on the template and fabricatea transitional prosthesis. The implants are installed using the templateand a transitional prosthesis is arduously adapted to temporarycylinders which are screwed to the implants. Several months later afterosseointegration, impressions are taken yet again and the final dentalprosthesis is fabricated and installed on the osseointegrated implants.While this freehand or unguided procedure works, it takes a substantialamount of labor and time for the patient to finally be fitted with theirfixed prosthesis.

There have been many attempts over the last several years to resolve theissues identified above so that the procedure of installing the finalprosthesis, as originally conceived, can be accomplished in a singlevisit to the dentist. None of the fixes proposed in the art have beensuccessful.

There is therefore a need in the art for a device and system which willalign the position of the final prosthetic device with the implants in areliable fashion, thereby simplifying the installation of the finalprosthetic device and thus substantially reducing the time and effortrequired to complete this installation.

BRIEF SUMMARY OF THE INVENTION

The present invention comprises a device and system which uses the NobelBiocare ALL-ON-4 system but modifies it so that the system will now workin the way it was originally conceived. The device and system of thepresent invention cuts down the number of visits the patient has to maketo the dentist and enables the dentist to install the implants and thefinal fixed prosthesis in a single visit. The patient can come incompletely toothless and leave with their final fixed prosthesis safelyand properly installed in a matter of hours.

The device, system and method of the present invention include all ofthe previously mentioned elements of the Nobel Biocare ALL-ON-4 systemplus a new component, a cradle. The cradle engages a portion of theprosthesis and retains the same adjacent a surgical site in a desiredorientation and position during installation of the prosthesis. Inparticular, the cradle is configured to engage a final dental prostheticdevice and is then used to position and orient the same on the patient'sjaw. The cradle particularly positions and orients the final prosthesisin the oral cavity in exactly the same position as was designed on thecomputer and in the lab. In essence, the cradle is a docking stationthat creates a fixed, immovable landmark by which to precisely orientthe final prosthesis in the mouth. Additionally, the final prosthesisincludes holes that are fabricated to be slightly bigger than thediameter of the titanium cylinders on the implants. This disparityallows the final prosthesis to slide, without interference, down overthe cylinders until the prosthesis clicks into the cradle.

The invention therefore comprises a cradle, assembly, system and methodfor installing a prosthesis at a surgical site. The cradle temporarilyengages the prosthesis and holds it in the correct orientation andposition adjacent the surgical site. An aperture is defined in thecradle and a portion of the prosthesis is received therein. In oneembodiment, the cradle, assembly and system are used to install a finaldental prosthesis in a patient's mouth in a single visit to thedentist's office. A securement member pins the surgical template andsubsequently the cradle to the jaw. A metal sub-structure on the finaldental prosthesis is received in the aperture in the cradle. Cylindersattached to implants anchored in the jaw extend through holes in thesub-structure and are bonded to the prosthesis. The cradle is detachedfrom the jaw and from the prosthesis prior to screws being re-insertedthrough the cylinders and into the implants.

In a first aspect, the invention is a cradle which engages a portion ofa prosthesis and retains the same adjacent a surgical site in a desiredorientation and position during installation of the prosthesis.

In another aspect, the invention is an assembly for installing aprosthesis at a surgical site in a patient's body, where the assemblyincludes: a surgical template which is temporarily positioned over thesurgical site and configured to identify one or more locations in thesurgical site for engagement of one or more anchoring members therein;and a cradle positioned over the surgical site once the surgicaltemplate is removed; said cradle being temporarily engaging a portion ofthe prosthesis and retaining the same adjacent the surgical site in adesired orientation and position.

In yet another aspect, the invention is a system for installing a finaldental prosthesis at a surgical site on a patient's jaw, said systemcomprising: a computer; programming installed in the computer; datagathered during a series of CT scans and being manipulable by theprogramming to cause one or more of a plurality of components to befabricated; and wherein the one or more of the plurality of componentsincludes: a surgical template; the final dental prosthesis; and a cradlewhich temporarily engages the final dental prosthesis and orients andpositions the same adjacent the surgical site on the patient's jaw.

In a first method of performing the invention, a final prosthesis isinstalled at a surgical site in a patient's body following the steps of:installing one or more implants in the patient's jaw; placing a cradleon the jaw and over the implants; positioning and orienting the finalprosthesis using the cradle; and fixing the final prosthesis to the oneor more implants; wherein the entire process from the installation ofthe one or more implants to the fixing of the final prosthesis theretooccurs in a single visit to the dentist's office.

Yet another method of performing the invention includes the steps of:installing one or more anchoring members at the surgical site; placing acradle adjacent the surgical site and over the implants; positioning andorienting the prosthesis using the cradle; and fixing the prosthesis tothe one or more anchoring members.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

A preferred embodiment of the invention, illustrated of the best mode inwhich Applicant contemplates applying the principles, is set forth inthe following description and is shown in the drawings and isparticularly and distinctly pointed out and set forth in the appendedclaims.

FIG. 1 is an illustrative exploded perspective view of a system inaccordance with the present invention including a surgical template thatis exploded away from the patient's jaw, a cradle, and the final dentalprosthesis;

FIG. 2A is a perspective view of the cradle in accordance with thepresent invention shown in FIG. 1, which cradle is a first embodiment ofthe invention and is configured for placement on the patient's lowerjaw, with the figure showing the interior surfaces of the cradle;

FIG. 2B is a perspective view of a second embodiment of the cradle inaccordance with the present invention, with this second embodimentcradle configured for placement on the patient's upper jaw, and showingthe interior surfaces of the cradle;

FIG. 3 is a bottom view of the final dental prosthesis shown in FIG. 1;

FIG. 4 is a perspective view of the final dental prosthesis shownengaged in the cradle of FIG. 1;

FIG. 5 is a cross-sectional view through the patient's lower jaw,showing the surgical template pinned to the jaw, and showing a pilothole being drilled in the jawbone;

FIG. 6 is a cross-sectional view through the patient's lower jaw asshown in FIG. 5, and showing an implant being torqued into the jawbone;

FIG. 7 is a cross-sectional view through the patient's lower jaw asshown in FIG. 6, showing the surgical template being removed from itsplacement on the lower jaw and showing the implant installed in thejawbone;

FIG. 8 is a cross-sectional view through the patient's lower jaw with acylinder engaged with the implant and showing a block-out agent beingapplied around the base of the cylinder;

FIG. 9 is a cross-sectional view through the patient's lower jaw showingthe cradle engaged with the jaw, the cylinder extending through anaperture in the cradle, and showing the final dental prosthesis beinglowered into engagement with the cradle;

FIG. 10 is a cross-sectional view through the patient's lower jawshowing the final dental prosthesis engaged with the cradle, having thecylinder extending through a hole in the final dental prosthesis andshowing a bonding agent being applied to bond the prosthesis andcylinder together;

FIG. 11 is a cross-sectional view through the patient's lower jawshowing the prosthesis with the cylinder engaged therewith and thecradle being removed from the patient's lower jaw;

FIG. 12 is a partial cross-sectional view of the final dental prosthesisshowing the cradle detached therefrom and showing a bonding agent beingapplied to a channel in the final dental prosthesis and around thebonded cylinder;

FIG. 13 is a cross-sectional view through the patient's lower jawshowing the final dental prosthesis placed on the jaw, with the cylinderengaged with the implant in the jaw and showing, in phantom, a screwsecuring the final dental prosthesis to the implant; and

FIG. 14 is a top view of a cradle in accordance with the inventionpositioned on a mold and showing a separate titanium sub-structure thatis separately cast or molded using the mold and is configured forsubsequent engagement with the cradle.

Similar numbers refer to similar parts throughout the drawings.

DETAILED DESCRIPTION OF THE INVENTION

As indicated previously, the inventor contemplates that the device,system and method of the present invention will be useful for installinga wide variety of prosthetic devices. By way of example, the followingdescription relates to the installation of a fixed dental prosthesisutilizing the device, system and method of the present invention. Itwill be understood, however, that the installation of other prostheticdevices utilizing a cradle or docking station type device to engage theprosthetic and correctly orient, position and hold that prosthetic at asurgical site to enable anchoring devices to be correctly securedthereto are also contemplated to fall within the scope of the presentinvention.

Dental prosthetic devices are installed in patients' mouths using one oftwo possible procedures. The first procedure will be referred to as“guided installation” and the second procedure will be referred to as“freehand or non-guided installation”. Guided installation is aninstallation utilizing the previously discussed Nobel Biocare system.Freehand installation is an installation where the prosthetic device isfabricated without the use of CT scans, computer's etc., where thedentist determines the placement of implants etc. This description willfocus initially on the guided procedure and then on the freehandprocedure.

Referring to FIG. 1 there is shown an exploded dental prosthetic systemin accordance with the present invention, generally indicated by thereference number 10. System 10 is shown by way of example only as beingconfigured for installation on a patient's lower jawbone 12 but it willbe understood that the system and components could be used on apatient's upper jawbone or partial regions of either of the upper andlower jawbones. It should also be understood that the figures areillustrative of the principles of the invention and the exact shape ofthe various components will be fabricated to be complementary to thepatient's exact oral configuration. The figures therefore should not beconstrued as limiting the scope of the invention insofar as the shape ofthe various components is concerned.

In accordance with the present invention, system 10 comprises a surgicaltemplate 14, a cradle 16, and a dental prosthesis 18. The dentalprosthesis 18 preferably is not a transitional prosthesis but is,instead, the final or fixed prosthesis to be installed in the patient'smouth as their “permanent” set of teeth. System 10 further includes atleast one, and preferably four, anchoring members. The anchoringmembers, in the case of a dental prosthesis 18, are implants and arereferenced in the figures by the number 38. (It will be understood thatany suitably configured implant or other suitable fastener for securingthe final prosthesis to a surgical site 13 is contemplated to fallwithin the scope of the present invention.) The surgical template 14,cradle 16, prosthesis 18 and anchoring members, i.e., implants 38, areconfigured to be used in such a manner that a patient can be taken froman edentulous state (i.e. toothless) or partially edentulous state, tohaving the final fixed dental prosthesis 18 fully installed in a matterof hours and in a single visit to the dentist's office.

It will be understood that surgical template 14, prosthesis 18 andanchoring members (implants 38) and their previously known methods ofuse in both guided and freehand installations are well known in the artand have been described in the Background section of this application.Consequently, the following description will relate to the surgicaltemplate 14, final prosthesis 18 and implants 38 only in sufficientdetail to assist in understanding the present invention and how it isused. What will be further described herein are any changes to thesecomponents or the way they are used and which changes have been made inaccordance with the present invention.

Cradle 16 is novel and, to the inventor's best knowledge, is not knownin the art. Thus, the present invention is directed to cradle 16, adental system for installing a final prosthesis 18 utilizing cradle 16,a kit incorporating cradle 16, and a method of installing a finalprosthesis 18 which includes using cradle 16 to position and orient theprosthesis 18. Still further, the present invention is directed to adevice and method for correctly orienting and positioning a prostheticdevice on a surgical site on a patient's body, particularly to a deviceand method for placing a fixed or final dental prosthetic on a patient'supper or lower jaw.

The template, 14, prosthesis 18 and anchoring assemblies 38 which areknown will now be described in somewhat greater detail and in particularwith reference to their use in a guided installation. As has beendescribed in the Background of this application, surgical template 14and prosthesis 18 are fabricated after data relating to the patient'supper or lower jaw and any previously worn non-fixed or fixed dentureshave undergone CT scanning.

Still referring to FIG. 1 surgical template 14 as illustrated isconfigured to be seated on the patient's lower jaw and comprises a firstwall 14 a, a first sidewall 14 b and a second sidewall 14 c. First andsecond sidewalls 14 b, 14 c extend outwardly away from first wall 14 aand define a channel 15 therein which is configured to follow anexterior contour of the gum tissue 22 surrounding the patient's jawbone12. The first wall 12 a of the patient's jawbone covered by tissue 22comprises the surgical site 13 onto which final prosthesis 18 is to beinstalled.

When surgical template 14 is seated on the patient's lower jaw, theinterior surface of first wall 14 a of template 14 will be seated ontissue 22 on top surface 12 a of jawbone 12, i.e., on surgical site 13.The interior surface of first sidewall 14 b will be disposed adjacentthe front region 12 b of jawbone 12 and second sidewall 14 c will bedisposed adjacent the rear region 12 c of jawbone 12. Surgical template14 is fabricated to define at least one aperture 30 therein. Preferably,template 14 defines four apertures 30 therein, with each aperture 30being in a specific location selected by the computer program and thedentist manipulating that program. (In other applications, the finalprosthesis may require more implants to anchor it and the surgicaltemplate 14 will then be provided with that complementary number ofapertures 30.) The location of each aperture 30 indicates to the dentistthe exact position in which he or she needs to drill pilot holes 32(FIG. 5) for placement of one of the implants 38, as will be hereinafterdescribed. The dimensions of surgical template 14 are exact andapertures 30 in template 14 are exactly sized to receive implants 38therethrough.

As is well known in the art, prosthesis 18 is configured to becomplementary to at least a portion of jawbone 12 and gum tissue 22 wheninstalled in the patient's mouth. Prosthesis 18 is shown in FIGS. 1, 3and 4 as including a first wall 18 a, a first sidewall 18 b, and asecond sidewall 18 c. Prosthesis 18 includes a first region comprising aplurality of teeth 26 and a simulated gum 27, and a second region whichis a sub-structure 19, preferably made of a non-reactive metal. Ashallow channel 28 is defined in the interior surface of sub-structure19, i.e., in the surface spaced from the simulated gum 27. Preferably,sub-structure 19 is fabricated from titanium and is fixedly secured tofirst wall 18 a and generally forms part thereof. At least a portion ofsub-structure 19 extends outwardly beyond the rest of first wall 18 a,as is shown in FIG. 1.

Prosthesis 18 is secured to the patient's jaw using an anchoringassembly. The term “anchoring assembly” used in this description denotesany and all fixtures and fasteners that are known in the art for use ininstalling and securing a fixed prosthesis 18 in place. As such,anchoring assemblies may include, but are not limited to, securementmembers 35, for example pins; anchoring members, for example, implants38; and screws 42. Anchoring assemblies may also in some instancesinclude angled abutments. Securement members 35 are used for temporarilypinning surgical template 14 and, in accordance with the presentinvention, pinning cradle 16 in the patient's mouth, as will bedescribed further herein. Implants 38 are configured to anchorprosthesis 18 to jawbone 12. Screws 42 are used to secure prosthesis 18to implants 38 via cylinders 40, as will be described hereafter. Theangled abutments may be engaged with the upper ends of implants 38,particularly if those implants are engaged with jawbone 12 at an anglethat makes it difficult to secure prosthesis 18 thereto. If angledabutments are utilized, then screws 42 will be used to secure prosthesis18 to those angled abutments. In accordance with the present invention,the anchoring assemblies also includes cylinders 40, i.e., cylindricalor sleeve type abutments. Cylinders 40 engage implants 38 and extend thelength thereof into the oral cavity and particularly extend to engageprosthesis 18.

Referring to FIGS. 1 and 2A there is shown a first embodiment of acradle 16 in accordance with the present invention. Cradle 16 isconfigured to be placed on a patient's lower jaw. Cradle 16 has beeninvented by the present inventor to be a type of “docking station” tocorrectly position and orient prosthesis 18 in the patient's mouth. Moreparticularly, the use of cradle 16 diminishes the impact of positioningimplants 38 at less than optimum locations or orientations withinjawbone 12 relative to the locations and orientations selected by thecomputer program, as will be later described herein. In accordance withthe present invention, the computer program and machinery which isutilized to fabricate surgical template 14 and prosthesis 18 is alsoprogrammed to design and fabricate cradle 16 using the data gatheredduring the CT scan of the patient's oral cavity. The computer programcauses cradle 16 to be fabricated preferably out of the same material assurgical template 14, i.e., out of a composite resin or an acrylicmaterial.

In accordance with the present invention, cradle 16 includes a firstwall 16 a, a first sidewall 16 b, and a second sidewall 16 c. First wall16 a, first sidewall 16 b and second sidewall 16 c bound and define achannel 24 that is complementary to the contours of gum tissue 22 aroundjawbone 12. When cradle 16 is positioned over jawbone 12, top region 12a of jawbone 12 is disposed in channel 24 adjacent the interior surfaceof first wall 16 a, front region 12 b of jawbone 12 is disposed adjacentfirst sidewall 16 b of cradle 16, and rear region 12 c of jawbone 12 isdisposed adjacent second sidewall 16 c of cradle 16.

In accordance with yet another feature of the present invention, thecomputer program causes cradle 16 to be fabricated so that it includesan engagement means configured to be complementary to a portion ofprosthesis 18. The engagement means enables prosthesis 18 to becomeengaged with cradle 16 when the two components are brought together. Theengagement means on cradle 16 preferably is an elongate aperture 34defined in first wall 16 a. This aperture 34 is configured to becomplementary to the peripheral edge of the titanium sub-structure 19 offinal dental prosthesis 18. Cradle 16 and prosthesis 18 are configuredto engage each other so that they act as a single unit. Sub-structure 19may be snap-fittingly engaged in aperture 34 and have an interferencefit therewith to substantially prevent prosthesis 18 from becomingaccidentally disengaged from cradle 16. However, this interference fitis not absolutely necessary for the functioning of cradle 16 andsub-structure 19 may be somewhat loosely engaged in aperture 34.

Sub-structure 19 of the finished final prosthesis 18 defines at leastone aperture, and preferably four apertures, 36 therein. Each aperture36 is sized slightly larger than the maximum diameter of the implants.(In previously known final prosthetic devices, the titaniumsub-structure included small screw holes through which screws wereinserted to engage the implants. These small screw holes are sizedexactly big enough to receive the small screws therethrough.) Each hole36 in sub-structure 19 is configured to positionally align with one ofthe apertures 30 in surgical template 14. This arrangement ensures thateach hole 36 will ultimately be able to generally align with one of theholes 32 drilled in jawbone 12. However, as indicated in the Backgroundportion of the present application, during actual surgery the holes 32are frequently not positioned sufficiently accurately enough that theholes 36 in prosthesis 18 will be able to align therewith. Consequently,in accordance with the present invention, the holes 36 formed insub-structure 19 are made slightly bigger than the exterior diameter ofthe cylinders 40. Holes 36 in sub-structure 19 are therefore slightlybigger than the corresponding apertures 30 in surgical template 14. Theslightly bigger holes 36 compensate for and allow slight or significantvariations (in 3 dimensions) in the position of implants 38 which areinserted into holes 32 in jawbone 12. In other words, the slightlybigger holes 36 provide some tolerance in the system.

As illustrated in FIG. 2B, if the prosthesis 18 is to be placed on thepatient's upper jaw, a slightly differently shaped cradle, indicated byreference character 16′, is fabricated under direction of the computerprogram. Cradle 16′ is substantially identical to cradle 16 andtherefore includes a first wall 16 a′, a first sidewall 16 b′, and asecond sidewall 16 c′. However, cradle 16′ also includes a palate region25 which is complementary shaped to abut at least a portion of thepatient's upper palate. Cradle 16′ defines an aperture 34′ therein thatis configured to be complementary to the sub-structure on an associatedprosthesis (not shown) for the patient's upper jaw. Cradle 16′ isconfigured to snap-fittingly engage that sub-structure to secure cradle16′ and the upper jaw prosthesis together in the same fashion as cradle16 engages prosthesis 18. Cradle 16′ has the same exact dimensions asthe dentures or wax dentures that were used during the CT scan. (Itshould be noted that this also true for cradle 16).

The present invention is used in the following manner. In a first guidedmethod, the patient's oral cavity and denture is CT scanned as describedpreviously herein in the Background portion hereof, and the datagathered during these scans is used to fabricate surgical template 14,the titanium sub-structure 19 for prosthesis 18, and, in accordance withthe present invention, the new component i.e., the cradle 16. Surgicaltemplate 14 and cradle 16 take their dimensions from the denture usedduring the CT scan. The computer uses this information to generate amilled pattern replica out of a clear composite material that isidentical to the denture relative to its tissue-fitting surface andborder extensions. The parts are milled to different specificationsdepending on whether it's the surgical template 14 (which has typicallyfour pre-drilled holes for implants 38) or a continuous aperture 34 inthe case of cradle 16. The finished prosthesis 18 is exactly patternedoff the scanned denture as well. Apertures 30 are drilled into surgicaltemplate 14 and are designed to position the implants, at the time ofsurgery, in exactly the same position in the mouth as designed on thecomputer. These pre-drilled apertures 30 are precisely extrapolated fromthe designed position of the implants. The optimum placement for theimplants 38 is displayed on the computer but, as indicated previously,it is basically impossible for the dentist to attain this optimumplacement of the implants 38 during the actual surgery.

The computer program will also generate a list of the required fixturesand fasteners that constitute the anchoring assemblies referencedearlier herein. These fixtures and fasteners are assembled into arraysfor use during surgery. It should be noted that because of theintroduction of cradle 16 into the system by the present inventor, thelength of the cylinders 40 used in this type of surgery are custommilled and are considerably shorter than previously used temporarycylinders as described earlier herein for use with transitionalprostheses. However, in the present invention which incorporates cradle16, cylinders 40 are able to be made to the correct length so that theywill typically not need to be cut down at all in order to besubstantially flush with the mouth-facing wall of the prosthesis 18.This feature not only saves time for the dentist during installation ofprosthesis 18 but also provides customized cylinders to meet thepatient's exact specifications.

When all of the components of the system of the present invention arefabricated and the anchoring assembly arrays are ready, the manufactureror supplier will ship a kit to the dentist which includes surgicaltemplate 14, prosthesis 18 including sub-structure 19, cradle 16 and theanchoring assembly arrays. All of these components will preferably beshipped to the dentist at the same time. As has been indicatedpreviously herein, the prosthesis 18 used in the present invention isthe final dental prosthesis for the patient, not a temporary ortransitional component. Thus, the present invention preferablyamalgamates all of the components for installation of the final dentalprosthesis into a single shipment which, again, saves the manufacturertime and money. The present invention also saves the dentist time andmoney as he can perform the surgery all in one single visit instead ofmultiple visits as was the case with the previously known system. Thepresent invention also saves the patient time, pain, mental trauma andinconvenience. This is because the surgery and installation is performedin a single visit and the patient is able to use the final dentalprosthesis immediately and does not need to return to the dentist at alater time to have the final prosthesis placed. Because the patient goeshome with the final prosthesis in place, they are immediately able touse their teeth as though they were their own.

Referring to FIG. 5, once the surgery begins, the dentist will placesurgical template 14 over the gum tissue 22 at the surgical site 13 onthe patient's lower jaw. Surgical template 14 is designed and fabricatedto include one or more holes (not shown) in first sidewall 14 b andthrough which a securement member 35 is inserted to pin template 14 tojawbone 12. Securement members 35 are inserted generally at right anglesto first sidewall 14 b, through gum tissue 22 and into an area of thefacial buccal bone. (A hole may be pre-drilled in the buccal bone toreceive each securement member 35.)

Once surgical template 14 is properly pinned on jawbone 12, the dentistwill remove a small plug of gum tissue 22 and then drill pilot holes 32into jawbone 12 through apertures 30 of surgical template 14. Thedrilling is accomplished using a series of suitably sized drill bits asprescribed by the Nobel guide protocol.

Referring to FIG. 6, implants 38 are then inserted through apertures 30in surgical template 14, while it is still pinned in place, and intopilot holes 32. Implants are torqued or fixed into place in accordancewith the manufacturer's specifications. If implants 38 are, for anyreason, under or over-rotated into jawbone 12 during this procedure, itdoesn't matter as the slightly oversized holes 36 in sub-structure 19 offinal prosthesis 18 will compensate for this and will allow slight orsignificant variations in implant position (in three dimensions) to bemanaged. As shown in FIG. 7, once implants 38 are in place in jawbone12, surgical template 14 is un-pinned (by removing securement members35) and the template 14 is removed from the patient's mouth.

The custom-milled cylinders 40 are initially independent of finalprosthesis 18 and are joined thereto at the time of placement aftersurgery. FIG. 8 shows a cylinder 40 engaged with the upper region ofeach implant 38. A screw 42 (shown in phantom) is used to securecylinder 40 to the associated implant 38. Polyvinyl Siloxane (PVS—alsoknown as vinyl polysiloxane (VPS)) or any other suitable block-outmaterial, referenced by the number 39, is then applied around theexterior base of each cylinder 40. The PVS is applied adjacent thesurgical site 13 to prevent any acrylic or cement (to be applied laterin the process) from contacting the gum tissue 22 and damaging orirritating the same. Cylinders 40 are now extending outwardly from topface 12 a of jawbone 12, as shown in FIG. 8.

FIG. 9 shows cradle 16 being seated on the patient's lower jaw 12 suchthat the jawbone and surrounding gum tissue 22 is received in channel 24of cradle 16. When cradle 16 is so seated, first wall 16 a thereof isadjacent top face 12 a of jawbone 12 i.e., adjacent surgical site 13;first sidewall 16 b is adjacent first sidewall 12 b of jawbone 12 andsecond sidewall 16 c is adjacent second sidewall 12 c of jawbone 12.Cylinders 40 extend outwardly through aperture 34 of cradle 16. Cradle16, like surgical template 14, has one or more holes (not shown)fabricated in first sidewall 16 b to receive a securement member 35therethrough. Securement members 35 are engaged with cradle 16, witheach pin 35 being inserted into one of the same holes (not shown) in thebuccal bone as was used during pinning of surgical template 14. Thisarrangement temporarily secures cradle 16 in place in the patient'slower jaw so that it does not substantially shift thereon duringengagement of prosthesis 18 with the engagement means, i.e., withaperture 34.

Prosthesis 18 is then lowered onto cradle 16 and into engagementtherewith as shown in FIGS. 9 and 10. Specifically, sub-structure 19 ofprosthesis is received into aperture 34 in cradle 16. Preferably,sub-structure 19 is snap-fitted into aperture 34. As this occurs, careis taken to ensure that each one of the cylinders 40 passes through itsappropriate and prescribed hole 36 in sub-structure 19 withoutinterference. When cradle 16 and prosthesis 18 are snapped together,they form the total pattern of the scanned denture. FIG. 10 shows thecradle 16 and prosthesis 18 engaged with each other in such a way thatfirst wall 16 a of cradle 16 is disposed adjacent an interior surface ofsub-structure 19. More specifically, cradle 16 is received within achannel formed by an interior surface of sub-structure 19. FIG. 10 alsoshows prosthesis 18 positioned and oriented on the jaw by cradle 16,with cylinders 40 extending through holes 36 in sub-structure 19 ofprosthesis 18. It will be understood that cradle 16 and prosthesis 18may, alternatively, be snap-fittingly engaged with each other prior tocradle 16 being inserted into the patient's oral cavity and beforesecurement members 35 are utilized to pin cradle 16 in place.

The interference fit between sub-structure 19 and cradle 16 ensures thatprosthesis 18 is correctly positioned and oriented in the patient'smouth. Because of the slightly larger size of holes 36 in sub-structure19 and because implants 38 are positioned in the jaw through apertures30 in template 14, the improved tolerance of holes 36 ensures that oneor more cylinders 40 do not accidentally engage a region ofsub-structure 19 instead of passing through the holes 36 therein. Theslightly larger holes 36 further ensure that cylinders 40 do notprotrude into the mouth beyond prosthesis 18. Thus, prosthesis 18 isoriented in exactly the same position, in three dimensions, as set up onthe computer and in the lab ensuring exact aesthetics, bite, occlusion,vertical dimensions of occlusion (VDO) as set up in the lab and as perthe CT scan.

If there is no interference fit between cradle 16 and prosthesis 18, theprosthesis 18 will simply be loosely seated in aperture 34. Duringbonding of cylinders 40 to prosthesis 18 the dentist will simply holdthe prosthesis 18 in contact with cradle 16, without departing from thepresent invention.

Referring to FIGS. 10 and 11, a cotton plug 52 is placed in the screwaperture 54 of each cylinder 40 to prevent that aperture 54 from beingblocked during the next phase of the process. Cylinders 40 are luted tosecure them to prosthesis 18, i.e., intra-oral acrylic cement or luting56 is applied around the circumference of each cylinder 40 to fill upthe hole 36 and to bond cylinder 40 and prosthesis 18 together. Theluting 56 is given time to set. When the material has set, the cottonplug 52 is removed from each cylinder 40 and the associated screw 42(shown in phantom) is unscrewed to break the engagement between thecylinders 40 and implants 38. Securement members 35 are withdrawn fromcradle 16 and once this is completed, prosthesis 18 with cylinders 40bonded thereto and with cradle 16 attached, is removed from thepatient's jaw and his or her mouth.

Cradle 16 is then detached from sub-structure 19 of prosthesis 18 (FIG.12) and the prosthesis 18 with cylinders 40 still bonded thereto iscleaned to remove any excess acrylic or cement, as well as any bloodtherefrom. The channel area on the interior surface of sub-structure 19surrounding cylinders 40 is then filled with acrylic cement 56. Acryliccement 56 is also utilized to fill any hollows or gaps on the oppositeside of prosthesis 18, particularly those surrounding cylinders 40. Thecylinders 40 are now fixedly bonded to prosthesis 18 and are trimmed, ifnecessary. The prosthesis 18 is now completely ready for finalplacement, and it is polished and sterilized.

FIG. 13 shows prosthesis 18 being positioned for a final time in thepatient's oral cavity so that it is seated adjacent the surgical site 13on the patient's jaw, and so that the cylinders 40 engage the topregions of implants 38. A screw 42 (shown in phantom) is insertedthrough the aperture 54 of each cylinder 40 and is rotated to asufficient degree to securely fix cylinder 40 and therefore prosthesis18 to the associated implant 38.

It has been found that utilizing the devices, system, and methodologydescribed above results in the dentist being able to take a patient froma substantially edentulous state to having the final prosthesis 18secured in the correct orientation and position on the patient's jaw inaround 3 hours. In the previously known system it typically took around5-7 hours for a transitional prosthesis to be placed in a patient's oralcavity and the entire prior art procedure had to be redone in 6-8 monthsin order to secure the final prosthesis in the patient's mouth. Thus,the present invention has taken a time-consuming, labor-intensive, andtechnique-sensitive procedure and has reduced it to a single procedurethat takes a few hours with the patient leaving the surgery with a finalfixed prosthesis in place.

It will be understood that while the above description has indicatedthat the present invention is suitable for use with the Nobel BiocareALL-ON-4 system, the present invention is also suitable for use with awide variety of other dental systems such as those manufactured andmarketed by Biomet 3i of Warsaw, Ind.

The above-described procedure is directed to the guided installation ofprosthesis 18 incorporating the cradle 16 in accordance with the presentinvention. As previously indicated, it is also possible to installprosthesis 18 in a freestyle or unguided manner. The previously knownfreestyle or unguided installation has been described in the Backgroundportion of this specification. In addition to the steps described in theBackground and in accordance with the present invention, the dentist ordental technician will craft the cradle 16 in additional to crafting theprosthesis 18 and surgical template 14. Cradle 16 will be hand-made inthe lab from an acrylic material by casting or molding the same tocreate the desired shape. FIG. 14 shows a plaster model 160 producedafter the taking of an impression of the patient's oral cavity. Anacrylic cradle 116 is crafted by the dentist or dental technician and isshown in this figure engaged on model 160. Cradle 116 defines a singleaperture 134 therein and through which a region 160 a of model 160projects. Model 160 is also separately utilized to shape a titanium orcast sub-structure 119 which will be fixed to the dental prosthesis. Thesub-structure 119 is substantially identical in shape to region 160 a sothat when sub-structure 119 is incorporated into the prosthesis, it willbe able to snap-fittingly or interferencially engage cradle 116. Region160 a is shown with markings 168 thereon which signify the locations atwhich the dentist or dental technician will form apertures 136 insub-structure 119. The apertures 136 perform the same function asapertures 36 in sub-structure 19. Cradle 116 performs the same functionas cradle 16 and does so in the same manner.

When the surgical template (not shown but substantially identical tosurgical template 14), cradle 116 and the final dental prosthesisincorporating sub-structure 119 (not shown but substantially identicalto prosthesis 18) have been made by the dentist or dental technician,the rest of the method of utilizing these various components and placingthe final dental prosthesis is substantially identical to the methoddescribed with reference to the guided installation.

Prior to the development of the present invention, Nobel Biocare wouldinitially send two items to the dentist for the initial surgery, namely,the surgical template and the implants. Then several months later afteranother round of impressions, bite registration and try-ins, Nobel wouldsend the dentist the final prosthesis. Even with the procedure asexplained in the Background portion of this specification, on occasion,dentists would still find it necessary to make alterations to the finalprosthesis before it could be seated properly in the patient's mouth.

With the system of the present invention, however, Nobel Biocare shouldbe able to send one package to the dentist for the surgery. That singlepackage will contain the surgical template, the implants, the cradle ofthe present invention, the final prosthesis, and all fixtures andfasteners necessary to accomplish complete installation of the finalprosthesis. At the end of the surgery, the patient will leave thedentist's office in a matter of hours with their final, fixed dentalprosthesis in place and ready for use.

While cradles 16, 16′ and 116 have been illustrated and described asdefining an aperture (34 or 34′) therein and into which thesub-structure 19 for the dental prosthesis 18 is engaged, it will beunderstood that cradle 16 may be differently configured to have adifferent engagement means which will engage the dental prosthesis insome other manner without departing from the scope of the presentinvention. For example, the cradle may be formed to have two arms thatare separated from each other by a gap, and the arms are configured tocapture a portion of the dental prosthesis between them. Alternatively,the cradle may be provided with some type of clamping mechanism orfastening mechanism which could be temporarily engaged with theprosthesis to retain the cradle and prosthesis together in asubstantially fixed orientation and position relative to each other.

Still further, the cradle 16 is described herein as being securedadjacent a surgical site 13 against movement by way of securementmembers 35. It is contemplated by the inventor that other types ofsecurement means may be utilized to temporarily hold cradle adjacent thesurgical site 13 without departing from the scope of the presentinvention. For example, instead of using securement members 35, sometype of clamping mechanism or strap mechanism may be utilized totemporarily retain the cradle adjacent the surgical site 13. Any suchdifferent securement means may be used to substantially prevent cradle16 from moving during engagement of prosthesis 18 therewith or duringpartial attachment of the prosthesis (when engaged with the cradle) toanchoring members in the tissue or bone at the surgical site 13. Asindicated previously herein, the inventor contemplates that a cradle andsecurement means in accordance with the present invention could be usedfor positioning and orienting a wide variety of prostheses at theirrespective surgical sites.

It will be understood that if for some reason the titanium sub-structureis fabricated as more than one piece and bonded as such into finalprosthesis 18, then cradle 16 would be configured with a sufficientnumber of apertures that are complementary to that differently shapedsub-structure 19 to permit the prosthesis and cradle 16 to be engagedwith each other.

There are certain applications where it would be advantageous where theengagement means on the cradle 16 in accordance with the presentinvention is not a single continuous aperture, such as aperture 34. Insuch cases it is deemed necessary or desirable to have final prosthesis18 not come into contact with gum tissue 22. In such cases prosthesis 18would need to sit above the gum 22, without touching it. In these casesthe cradle, which is not shown in the drawings, would function inexactly the same manner as cradle 16, with the exception that infabrication the cradle would be formed to have at least one andpreferably four apertures corresponding to the position of the implants38 in jaw 12. These apertures would be slightly oversized to allow forvariations in implant position as described earlier. The cylinders 40for engagement with implants 38 would be fabricated to protrude throughthe apertures in the cradle and into the final prosthesis 18 through itssimilarly oversized holes 36. In this embodiment of the invention, thecradle would define a groove configured to be complementary to a portionof final prosthesis 18, preferably to sub-structure 19. This portion ofthe prosthesis 18 would snap-fittingly engage in the groove in thecradle in such a manner that prosthesis 18 would not become disengagedtherefrom during installation. The previously described PVS (VPS), orany other suitable other block-out material, would be applied to thejunction where the cylinders 40 meet the cradle (similar to thetechnique of applying the PVS (VPS) at the base of the cylinder where itmeets the surgical site 13). This would ensure that the acrylic cementemployed to bond the prosthesis 18 to the cylinders 40 doesn'tinadvertently flow into the oversized holes in the cradle, therebybonding the prosthesis 18 and cylinders 40 to the cradle. In such anapplication the cradle would be installed first, the holes therein beblocked out with PVS (VPS) and then the final prosthesis 18 snapped intothe cradle's groove. This method of ‘floating’ the prosthesis above thegum for hygienic purposes is regularly employed in the known art. Whenthe cradle in accordance with the present invention is incorporated intothe installation procedure, the cradle, with it's grooved versusaperture configuration, accommodates this “floating” technique.

It should be understood that should a dentist determine that it isnecessary, for some reason, to utilize a transitional prosthesis priorto installing the final prosthesis, the cradle in accordance with thepresent invention can be used to install a transitional prosthesis aswell as subsequently be used to install the final prosthesis. The use ofthe cradle in the installation of the transitional prosthesis using theabove-described method removes all of the problems associated with priorplacement protocols. Thus, when the term “final prosthesis” is used inthis specification, it should also be understood to also includetransitional prostheses under conditions where the cradle in accordancewith the present invention is used to place the same.

It is contemplated by the inventor that in some instances it may not benecessary, possible, or desirable to utilize cradle 16 during theinstallation of the final prosthesis 18. As has been indicatedpreviously herein, the presently known system has not been able topermit a dentist to complete the installation of a final prosthesisstarting with the placement of the implants right through to securingprosthesis in place in a single visit to the dentist's office. Theinventor has recognized that in some instances cradle 16 may be omittedfrom the process provided a change has been made to prosthesis 18 duringfabrication. In accordance with the present invention, prosthesis 18 isfabricated to include titanium sub-structure 19. During the fabricationof sub-structure 19 one or more apertures 36 are formed therein. Eachaperture 36 has an internal diameter of a first size. This firstdiameter is configured to be slightly larger than the maximum externaldiameter of the cylinder 40 which will ultimately be receivedtherethrough. During installation of prosthesis 18, one or more implants38 are installed in the patient's jaw and a cylinder 40 is engaged witheach of those implants 38. Prosthesis 18 is then positioned on thepatient's jaw so that cylinder 40 engaged with each implant 38 extendsthrough one of the one or more apertures 36 in prosthesis 18. Inaccordance with a particular feature of the present invention, thedifference in size between the exterior diameter of each cylinder 40 andits associated aperture 36 is such that a gap 57 is defined betweenthem. This gap 57 gives final prosthesis 18 the tolerance it needs toaccommodate implants 38 being installed in the jaw in a location otherthan the optimum location computed by the computer. Once prosthesis 18is positioned on the jaw with the one or more cylinders 40 extendingthrough the associated one or more apertures 36, it is possible tosecure prosthesis 18 to the one or more implants 38. This isaccomplished by securing cylinder 40 to the associated implant 38 andsecuring cylinder 40 to prosthesis 18. Cylinder 40 preferably is securedto its associated implant 38 by screwing a screw 42 through the bore ofcylinder 40 and into implant 38. Cylinder 40 is secured to prosthesis 18by closing gap 57 between the exterior wall of each cylinder 40 and thatportion of prosthesis 18 which defines the associated aperture 36through which cylinder 40 extends. This gap 57 may be closed in anynumber of ways. As disclosed in the attached figures, gap 57 is closedby applying a bonding agent, such as cement 56 into gap 57 and allowingthe cement 56 to set to secure cylinder 40 and prosthesis 18 together.Other methods of closing gap 57 may be employed without departing fromthe scope of the present invention. For example, some type of mechanicalbridging may be applies between the exterior wall of cylinder 40 andprosthesis 18. Alternatively, cylinder 40 may be of a type that is ableto expand so that its exterior wall advances toward the portion ofprosthesis 18 which defines aperture 36. In this latter instance,cylinder 40 will ultimately have an interference fit with the portion ofprosthesis 18 defining aperture 36. It will also be understood that acombination of these bonding agents, bridging mechanisms or mechanicalmechanisms may be utilized to secure cylinder 40 to prosthesis 18. Theentire installation procedure from the placement of the implants 38 tothe securement of the final prosthesis thereto, is able to be completedin a single visit to the dentist's office.

The present invention is also contemplated for use in surgeries otherthan dental surgeries for the installation of other types of prostheticdevices. In particular, the invention is contemplated to be useful forretaining other types of prosthetic devices in fixed orientations andpositions so that the prosthetic devices are able to be more accuratelypositioned at the surgical site than is currently possible. The inventorcontemplates that a docking station/cradle type device could beconfigured to interlockingly engage with prosthetic components used inhip replacement surgery, knee replacement surgery, or other orthopedicprocedures, for example. The cradle would be fabricated to becomplementary to the prosthetic it is to hold in the correct positionand orientation. The cradle will hold the prosthetic component in thedesired orientation and position during initial installation ofanchoring or fastening members to secure the prosthetic component inplace. The cradle would then be disengaged from the prosthetic componentand the installation of the anchoring or fastening devices would becompleted. The inventor further contemplates that the use of a cradle toposition and orient a prosthetic device could also be used in veterinaryapplications where the patient would be an animal.

In the foregoing description, certain terms have been used for brevity,clearness, and understanding. No unnecessary limitations are to beimplied therefrom beyond the requirement of the prior art because suchterms are used for descriptive purposes and are intended to be broadlyconstrued.

Moreover, the description and illustration of the invention are anexample and the invention is not limited to the exact details shown ordescribed.

The invention claimed is:
 1. A method of performing dental procedures ona portion of a bone segment of a patient's jawbone; said methodcomprising: providing a cradle comprising a cradle body having a firstwall and a second wall that are spaced apart from each other and areconnected together by a first end and a second end; wherein the firstwall and second wall are spaced apart and define an open surgical spacebetween them; wherein the surgical space connects a top of the cradlebody with a bottom of the cradle body; and wherein the bottom of thecradle body is contoured to the portion of the bone segment; placing thebottom of the cradle body on the portion of the bone segment; insertinga dental tool through the surgical space; and performing a first dentalprocedure on the portion of the bone segment using the dental tool;providing a dental appliance having a dental appliance body with a topand a bottom; wherein the dental appliance body defines one or moreaperture therethrough; providing contouring of the top of the cradlebody, wherein the contouring of the top of the cradle body conforms tothe bottom of the dental appliance body; removing the dental tool fromthe surgical space defined by the cradle body; engaging the bottom ofthe dental appliance body with the top of the cradle body; aligning theone or more apertures in the dental appliance body with the surgicalspace defined by the cradle body; inserting a dental component throughone of the one or more apertures defined in the dental appliance body;inserting the dental component through the surgical space defined in thecradle body; engaging the dental component in the portion of the bonesegment; drilling one or more receiving holes in the portion of the bonesegment; providing one or more holes in one or both of the first walland the second wall of the cradle body in locations that arecomplementary to the one or more receiving holes in the portion of thebone segment; aligning each of the one or more holes in the cradle bodywith one of the one or more receiving holes; inserting a fastenerthrough each of the one or more holes in the cradle body and into analigned associated one of the receiving holes; and temporarily anchoringthe cradle body to the portion of bone segment using the fasteners. 2.The method as defined in claim 1, further comprising: providing one ormore holes in the dental appliance body in locations that correspond tothe locations of the receiving holes in the portion of the bone segment;aligning each of the one or more holes in the dental appliance body withone of the one or more receiving holes; inserting a fastener througheach of the one or more holes in the dental appliance body and into analigned associated one of the receiving holes; and temporarily anchoringthe dental appliance body to the portion of bone segment using thefasteners.
 3. A method of performing dental procedures on a portion of abone segment of a patient's jawbone; said method comprising: providing acradle comprising a cradle body having a continuous first wall and acontinuous second wall that are spaced apart from each other and areconnected together by a first end and a second end; wherein the firstwall and second wall are spaced apart and define an open surgical spacebetween them; wherein the surgical space connects a top of the cradlebody with a bottom of the cradle body; and wherein the bottom of thecradle body is contoured to the portion of the bone segment; placing thebottom of the cradle body on the portion of the bone segment; insertinga dental tool through the surgical space; performing a first dentalprocedure on the portion of the bone segment using the dental tool;providing a dental appliance having a dental appliance body with a topand a bottom; wherein the dental appliance body defines one or moreaperture therethrough; providing contouring of the top of the cradlebody, wherein the contouring of the top of the cradle body conforms tothe bottom of the dental appliance body; removing the dental tool fromthe surgical space defined by the cradle body; engaging the bottom ofthe dental appliance body with the top of the cradle body; aligning theone or more apertures in the dental appliance body with the surgicalspace defined by the cradle body; inserting a dental component throughone of the one or more apertures defined in the dental appliance body;inserting the dental component through the surgical space defined in thecradle body; and engaging the dental component in the portion of thebone segment; drilling one or more receiving holes in the portion of thebone segment; providing one or more holes in one or both of the firstwall and the second wall of the cradle body in locations that arecomplementary to the one or more receiving holes in the portion of thebone segment; aligning each of the one or more holes in the cradle bodywith one of the one or more receiving holes; inserting a fastenerthrough each of the one or more holes in the cradle body and into analigned associated one of the receiving holes; and temporarily anchoringthe cradle body to the portion of bone segment using the fasteners. 4.The method as defined in claim 3, further comprising: providing one ormore holes in the dental appliance body in locations that correspond tothe locations of the receiving holes in the portion of the bone segment;aligning each of the one or more holes in the dental appliance body withone of the one or more receiving holes; inserting a fastener througheach of the one or more holes in the dental appliance body and into analigned associated one of the receiving holes; and temporarily anchoringthe dental appliance body to the portion of bone segment using thefasteners.